The neck is commonly one of the first visible signs of aging. The lower jaw line, lower face, and the neck are important for a youthful appearance. A youthful appearance is perceived by a straight, defined jaw line, smooth taut skin and a well defined mento-cervical angle (angle between neck and chin on a lateral view). Slightly loose skin and lines of the anterior part of your neck, are early signs of neck aging. Most patients first notice these signs by the shadows on photographs below the chin and lower jaw line. Jowls, vertical banding of the platysma, horizontal lines, double chin or a fatty “turkey neck” below your chin add to an “aging” appearance. The neck, is the middle part of an aesthetic unit composed of the face, the neck and cleavage. If one of them does not match, the appearance will be perceived as disharmonious. It does not matter if this is the case before or after aesthetic surgery. Therefore it is important that all 3 of them are harmoniously balanced, and importance of the neck is not overlooked.Many people have the impression that the fullness underneath their chin is only fat. Usually, it is a combination of loose skin, fat, and loose platysma muscles. Having a receding, narrow chin or mandible predisposes to the aging process by not providing bony support. Each patient should be examined and evaluated based on their individual anatomy and aging process. Fatty jowls, a “turkey neck,” vertical banding and horizontal creases all work together to make us look older than we often feel. A neck lift enhances the appearance of the neck by tightening the skin and underlying muscles and improving the contour of the jawline. This procedure is often performed in conjunction with liposuction, a facelift, or a cheek lift, but may also be done as a stand-alone procedure. When looking for facial rejuvenation, the correction of an aging neck with a surgical neck lift or other neck contouring procedures is pivotal.
Not every patient needs a „full“ neck lift. Dr Bianca Knoll will carefully analyze a patient’s distinctive features from the aging process, and will assess overall goals with a patient before the neck lift to ensure patient and doctor agree to the same term. A modern neck lift, like a facelift, is personalized for each patient’s unique circumstances. Most patients considering a neck lift are concerned about these 4 areas:
Younger patients with only an isolated submental fat pad, can be candidates responding to liposuction alone. Patients presenting with muscle laxity (platysmal muscle) or loose skin, will not be good candidates.
Looseness of muscle
The platysma muscle is a thin, broad muscle, just below the skin covering the neck on each side. The platysma muscles belongs to the so-called SMAS layer, which plays a central role in facelifts. The platysma muscle supports the neck. During the aging process the muscles change as well, alternating the appearance of the neck, and resulting in unattractive neck bands. Often a platysmaplasty can restore the youthful appearance of the neck. This neck lift procedure is often combined with contouring of the fatty tissue resulting in a well defined, youthful chin, neck contour. A good candidate for this procedure has some looseness of the platysma muscles, possibly some excess fat below the chin and neck, and good skin elasticity.
Skin laxity of the neck
Some minor degrees of loose skin will be able to be addressed by the above mentioned procedures. Redundant skin laxity will require surgical tightening, from a full neck lift procedure. A full neck lift will also address the jowls and restore the mandibular line. Sometimes this procedure is also brought into context with a lower facelift. The most natural result and least visible scarring is achieved by placing the incisions, similar to a lower face lift, within natural creases around the ear reaching to the hairline. In order to obtain a more dazzling, longer lasting result, additional work of the platysma muscle is usually included.
Lacking bony support
A small, narrow or receding chin and mandible predispose the facial aging process of the neck due to its lack of support. Although nobody really prefers to hear that, it just means that you may need a different type of neck lift or neck contouring procedure, than somebody in your same age group. Some patients opt for an additional genioplasty / chin surgery while having any type of neck lift or contouring performed.
During your consultation for a neck lift procedure Dr Knoll will carefully listen to your concerns, examine you and thoroughly analyze how the aging process has affected the neck and face. She will then discuss this with you, explain your available options, and present you some of her before and after cases. Not every patient thinking he or she will needs a neck lift will be a good candidate. Vice versa, some patients are hoping that a minor treatment or surgery will have the same effect, as a well performed surgical neck lift and facelift. This is very often not the case. Patients often realize that initial non-surgical treatments (incl Kybella, thread lifts, laser treatments, tightening procedures) are not enough anymore, and they are seeking a more compelling, and long lasting solution. In some patients this might be the case as early as in their late 30’s or 40’s, to maintain their best appearance. Some patients seeking a neck lift are often happy with their facial appearance but notice that the appearance of the face and neck do not appear harmonious. Overall they would like to restore the youthful and taut appearance of their neck. In other patients the neck lift is an integral part of their modern facelift procedure.We are happy to provide you with further information about your neck lift options and answer your questions during your consultation in Dr Bianca Knoll’s office in Frankfurt. We understand that it can be impractical for some of our out of town/international patients to travel to Frankfurt for an initial consultation. For this reason, Dr. Knoll offers online consultations. By submitting a series of photographs, information about yourself and desired outcome, we can start to determine if you are a good candidate. Though a virtual consult starts the consultation conversation, it does have its limitations and does not replace the need to be seen in person for a traditional consultation to finalize plans for a procedure.
There are different surgical approaches and incisions lines available, depending on the extent of the your neck lift surgery and the changes being performed. If a „corset“ platysmaplasty is planned (i.e, the midline edges of the platysma muscles are being brought together creating a smooth chin / neck contour) an inconspicuous short incision just behind your natural crease of your chin (submental incision) is made. In younger patients this approach will often be sufficient. In patients where a full neck lift will be performed, the incision line will be similar to a facelift incision with or without a submental incision. This means that the incision for the neck lift will go around the ear, reaching behind to your hairline. Careful and precise surgical technique, placing scars in natural light reflexion zones, or in areas of pigmentation changes, will make scars with proper healing, barely noticeable. The old times of neck lift and facelift surgery, leading to broad, long, noticeable scars, pulled earlobes, distorted hairlines are a things of the past thanks to advancements in aesthetic and plastic surgery. Dr Bianca Knoll and her team will also give you personalized post-operative care instructions to further reduce the visibility of your scars.
A platysmaplasty with or without contouring (i.e. fat removal) can either be performed under local anesthesia or general anesthesia in an ambulatory setting. More complex neck lift procedures are usually performed under light general anesthesia. Depending on the extent of your surgery (combination with a facelift) you may spend 3-6 hours in the operating room under light general anesthesia. Most of Dr Knoll’s neck lift procedures will be safely performed as a day procedure. Based on your general health, length of the procedure, and your personal comfort you may prefer an overnight stay in the hospital.
What to expect after neck lift or facelift surgery? The majority of our patients report that they have imagined the procedure to be more painful. Our patients describe some discomfort, and on rare occasions, some tightness. Patients will have some swelling and bruising, which gradually subsides within the first days to weeks. Most of the bruising will be gone around 10 to 14 days after your procedure. At the same time swelling and edema subsides. The amount of bruising and swelling can vary from patient to patient, but Dr Knoll’s office will provide you with helpful pre and post-operative care information. Although we abandoned the use of facial compression garments, in most cases, there are still some individuals in which we still find them to be useful. Dr Bianca Knoll and her staff will have your best interest at heart, and will do everything they can to have your surgery go well, and your recovery proceed smoothly, safely and with the least amount of discomfort possible.
We are happy to provide you with further information about the neck lift procedure and answer your questions during your consultation in Dr Bianca Knoll’s office in Frankfurt.
The costs of a neck lift surgery may vary depending on the technique used for your neck lift procedure. Usually there are 3 different costs associated with surgery: the surgeon’s fee, hospital fee, and anesthesia fee. Not all of those 3 different fees will apply if your surgery can be performed under local anesthesia.
Dr Bianca Knoll’s office in Frankfurt will provide you with a detailed cost proposal including all these 3 different costs after your consultation. During your office consultation with Dr. Knoll you will be thoroughly examined, allowing us to provide you with additional information prettying to surgery, pre-operative testing requirements and the cost associated with your individualized surgery plan. For these reasons a consultation in our Frankfurt office is strongly encouraged.
If you wish to have additional information or would like to schedule a consultation please contact the office of Dr Bianca Knoll, we will be happy to assist you.